Billing Representative Office Clerk

Yanilda Garcia

* ******* **** *******, ** ***** 845-***-**** *******.******@*****.***

OBJECTIVE

I am seeking employment that allows me to grow professionally while being able to utilize my skills for the betterment of the organization with the best use of my dedication, determination and resourcefulness.

EDUCATION

Hunter College New York, NY

Completion: June, 2005

Major: Bachelor’s in Accounting

EXPERIENCE

Bon Secours Health System (Good Samaritan Hospital), Denials Management Rep.

1/22-Present Suffern, NY

Following up on status of appeals

Filing appeals for technical denials

Verifying insurance payments were processed correctly to make sure no lines were denied

Reviewing and resolving denied patient insurance claims.

Analyzing denials trends on specific health insurance

Performing basic office duties such as, copying, faxing, scanning, mailing documents, etc

Bon Secours Health System (Good Samaritan Hospital), Follow Up Rep.

10/16-1/22 Suffern, NY

Submitting electronic and paper claims to different payers

Following up on inpatient and outpatient claims

Contacting patients when necessary

Billing and following on Commercial Insurance Hospital claims

Verifying that claims were processed accordingly in a timely manner

Performing basic office duties such as, copying, faxing, mailing documents, etc

Bon Secours Health System (Good Samaritan Hospital), Billing Liaison/Fee Negotiator.

9/15-10/16 Suffern, NY

Verified Patient’s health insurance for billing purposes

Entered and collected data into computer systems as requested

Registered and checked in patients thru Connect Care Systems

Performed basic office duties (copied, faxed, scanned, filed documents, handed charts)

Answered multiple, high volume phone calls

Lincoln Hospital, Hospital Care Investigator

06/07- 09/15 Bronx, NY

Verifying patients’ health insurance information in order to bill the proper insurance for hospital services rendered

Submitting electronic or manual claims to different insurance companies

Following up on accounts to insure maximization of revenue

Appealing denied claims

Experience with both outpatient & inpatient managed care billing

Contacting patients for any information required by the insurance companies

Verifying claims were paid under the correct rates and processing claims accordingly

Worked different Health Insurances, such as: Affinity, HIP, GHI, Health First, Metro Plus, & Health Plus.

Accesses patient information through Siemems, Omnipro, Online Account Managements(OAM), and Electronic Document Management (EDM) System.

Hunter College, Bursar’s office Clerk

09/2003- 12/2004 Bronx, NY

Answered multiple, high volume phone calls.

Entered data into computer system

Collected data requested

Performed basic office duties (Copied, faxed).

Hunter College, Intercollegiate Athletics

09/02-05/03 Bronx, NY

Coordinated games and events

Handed out sports equipment such as uniforms, balls, nets, etc

Hunter College, Chemistry professor’s assistant

09/02-05/03 Bronx, NY

Answered phone line

Entered data into computer system

Collected data requested

Made copies of documents

SKILLS

Microsoft Word, Microsoft Excel, Power Point, Bilingual (English and Spanish), Hospital Care Investigator-Certification, Hostos Community College Coding Certification Program.

Reference upon request

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